Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 3449 | SC |
NPI | 1740433465 |
---|---|
Provider Name | Mrs. Jennifer S Bunch |
First Address | Orangeburg, SC 29115-6022 |
Second Address | Orangeburg, SC 29115-6022 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2008 |
Last Update Date | 22/10/2021 |